Continuous Infusions vs Scheduled Bolus Infusions

Regional anesthetic techniques are an integral part to many anesthetic approaches, providing
both intraoperative and postoperative anesthesia and analgesia. Regional anesthesia
peripheral nerve blocks have been shown to reduce postoperative pain and improve measures
such as opioid requirements and readiness for discharge. By using a catheter technique for
continuous peripheral nerve blocks, analgesia can be extended well into post-operative days 2
and 3, further extending these benefits. Historically these catheters have implemented a
continuous dosing regimen of local anesthetic, but increasingly there is evidence of improved
analgesic outcomes without adverse effects by using a scheduled bolus dosing regimen. Many
institutions have implemented this new protocol for catheter dosing. The beneficial effect of
scheduled bolus dosing has not been studied in all blocks and all surgical procedures.

Inclusion Criteria: Enrollment will be offered to adult patients with ASA physical status
I, II, or III, presenting for nerve block catheters for post-operative analgesia.

Exclusion Criteria: Exclusion criteria will include: pregnancy, incarceration, age <18, BMI
>35, pre-operative opioid use >30 mg morphine equivalents per day, inability to communicate
with investigators by telephone, and pre-existing neuropathy of the operative extremity.